ES2559936T3 - Hip joint device - Google Patents

Abstract

A medical device for the treatment of osteoarthritis of the hip joint contributing to the injection of an artificial surface of the hip joint on the natural surface of the hip joint or on a natural surface of the hip joint surgically modified, wherein said medical device comprises a first closure element (84) adapted to be placed in the hip joint to create a hollow space together with the acetabulum, or an artificial replacement thereof, and the head of the femur, or an artificial replacement (45) thereof, wherein said first closing element has an elongated body adapted to close said hollow space confined by the surfaces of the acetabulum, or of an artificial replacement thereof, and of the head of the femur, or of an artificial replacement thereof, in order to receive, within said hollow space, a material (93) for r covering at least one of the acetabulum and the head of the femur, wherein said medical device further comprises a second closure element (86), wherein - said first and second closure elements define a closed hollow space (87) together with the head of the femur, or an artificial replacement thereof, and the acetabulum, or an artificial replacement thereof, and - said first and second closure elements are adapted to make contact with said material when said hollow space receives said material to cover at least one of the surface of the acetabulum and the surface of the head of the femur, and in which the device comprises said material, characterized in that said material is biocompatible and is adapted to be injected such that it is brought into contact with said first closure element, and wherein said biocompatible material is adapted to be transformed from a fluid state to a solid state after said material has been injected into said provisional mold, and wherein said material is adapted to have a surface that tolerates wear and pressure when said material is in said solid state.

Description

5

10

fifteen

twenty

25

30

35

40

Four. Five

fifty

DESCRIPTION

Hip joint device Technical sector of the invention

The present invention relates, in general, to a medical device for use in a surgical or laparoscopic procedure of treating osteoarthritis of the calera in a human patient.

Background

Osteoarthritis of the hip joint is a syndrome in which a low-intensity inflammation results in pain in the hip joints, caused by an abnormal wear of the cartilage that acts as a shock absorber inside the joint. the hip. This anomalous wear of the cartilage also results in a decrease in the joint lubrication fluid called synovial fluid. It is estimated that osteoarthritis of the hip joint affects 80% of the population over 65 years of age, more or less severely.

Current treatment of osteoarthritis of the hip includes NSAID medications, local injections of hyaluronic acid or glucocorticoid to help lubricate the hip joint, and replacement of parts of the hip joint with a prosthetic surgery. the hip joint.

The replacement of parts of the hip joint is one of the most common surgeries today, performed every year on hundreds of thousands of patients worldwide. The most common procedure involves placing a metal prosthesis in the femur and a plastic bowl in the acetabulus. This operation is performed through a lateral incision in the hip and upper thigh, and through the fascia lata and lateral thigh muscles. In order to gain access to the joint, it is necessary to penetrate the fibrous support capsule coupled to the femur and the ilium, which makes it difficult to achieve a fully functional joint after surgery. The femur is cut in the neck with a bone saw and the prosthesis is placed in the femur with bone cement or without it. The acetabulus is slightly enlarged using an acetabular stretcher, and the plastic bowl is placed using screws or bone cement.

Surgery usually requires a week of hospitalization due to the increased risk of infection. The recovery process lasts an average of approximately 6 weeks, but even after this period the patient should not perform any physical activity that involves a high effort on the joint.

The DE10339605 (Priebs) report discloses a polymorphic hip joint surface that can be filled with a lubricant and air.

Report US2009 / 076605 (from Linares) discloses a method of injecting a solidifying fluid into a mold placed in a joint.

Summary

A medical device for the treatment of osteoarthritis of the hip joint is disclosed by the arrangement of a surface of the hip joint. The hip joint comprises an acetabulus, which is a part of the pelvic bone, which comprises a surface of the acetabulus, and a head of the femur, which is a part of the femoral bone, which comprises a surface of the head of the femur. The medical device comprises a first closure element adapted to be placed in the hip joint to create a hollow space together with the acetabulum, or an artificial replacement thereof, and the head of the femur, or an artificial replacement thereof. The first closure element is further adapted to have a shape adapted to close the hollow space in order to receive, within said hollow space, a material to cover at least one of the surface of the acetabulum and the surface of the head of the femur.

In accordance with the invention, the medical device further comprises a second closure element. The first and second closing elements therefore define a closed hollow space, together with the head of the femur, or an artificial substitution thereof, and the acetabulum, or an artificial substitution thereof. In addition, the first and second closure elements are adapted to make contact with the material when the hollow space receives material to cover at least one of the surface of the acetabulum and the surface of the head of the femur.

In accordance with the invention, the material used in any of the embodiments herein is biocompatible. The material could also be adapted to be injected in contact with the first closure element, and be adapted to transform from a fluid state to a solid state after the material has been injected into the provisional mold. The material could also be adapted to have a surface that tolerates wear and pressure when the material is in a solid state.

Preferred embodiments of the invention are defined by the dependent claims. Keep in mind that any realization or part of realization can be combined in any way.

5

10

fifteen

twenty

25

30

35

40

Brief description of the drawings

The embodiments are described below, by way of example, with reference to the accompanying drawings, in which:

Figure 1 shows the hip joint in section,

Figure 2 shows a side view of a conventional hip joint surgery,

Figure 3 shows an artificial femur head that is used in conventional surgery,

Figure 4 shows the articulation of the hip in section when a hole is created in the pelvic bone,

Figure 5 shows the articulation of the hip in section when a small hole is created in the pelvic bone,

Figure 6 shows the hip joint in section when a hole is created in the femur,

Figure 7 shows the hip joint in section when a hole is created in the hip joint capsule,

Figure 8 shows the expandable stretcher,

Figure 9 shows the expandable stretcher in its folded state,

Figure 10 shows the expandable stretcher from below,

Figure 11 shows the expandable stretcher being used in the surgical or laparoscopic procedure,

Figure 12 shows the hip joint in section, in which a chamber is located in the hip joint,

Figure 13a shows an instrument for the introduction of a closure element in a hip joint,

Figure 13b shows the instrument for introducing a closure element in a hip joint, in section,

Figure 13c shows the instrument for the introduction of a closure element in a hip joint, according to a second embodiment,

Figure 14a shows an instrument for introducing a closure element in a hip joint, according to a first embodiment,

Figure 14b shows an instrument for the introduction of a closure element in a hip joint, according to a second embodiment,

Fig. 14c shows an instrument for the introduction of a closure element in a hip joint, according to a third embodiment,

Figure 15 shows the introduction of a first closure element in a hip joint, Figure 16a shows the introduction of a second closure element,

Figure 16b shows a closure element that is preassembled on a surface of the head of the artificial femur, Figure 17a shows the creation of a hole in the femur,

Figure 17b shows an instrument that can insert a closure element into a hip joint through the femur,

Figure 17c shows the placement of a closure element inside the hip joint using an instrument that works through the femur,

Figure 18 shows the placement of a closure element inside the hip joint using an instrument that works through the hip joint capsule,

Figure 19 shows the filling of a closed area inside the hip joint using an instrument that works through the pelvic bone,

Figure 20 shows the filling of a closed area inside the hip joint using an instrument that works through the femur,

5

10

fifteen

twenty

25

30

35

40

Four. Five

fifty

Figure 21 shows the filling of a closed area inside the hip joint using an instrument that works through the hip joint capsule,

Figure 22a shows a sectional hip joint, after a closed area in the hip joint has been filled with fluid,

Figure 22b shows an injector element that injects a fluid through a closure element, Figure 23 shows the injection of fluid into an area of the hip joint;

Figure 24 shows an injector element in greater detail,

Figure 25 shows an injector element in greater detail, according to a second embodiment,

Figure 26 shows an injector element in greater detail, according to a third embodiment.

Detailed description

A detailed description of the embodiments will be provided below. In the figures, similar reference numerals indicate identical or corresponding elements in all of the various figures. It will be appreciated that these figures are illustrative only and do not limit the scope in any way. Therefore, any references to addresses, such as "above" or "below", refer only to the addresses shown in the figures. Also, any dimensions, etc., shown in the figures, have illustrative purposes.

A resorbable material should be understood as a material that is adapted to be reabsorbed by the human body after some time of implantation, and therefore, at least partially, disappear from the implantation site.

A biocompatible material should be understood as a material with a low level of immune response. Biocompatible materials are sometimes called biomaterials.

Figure 1 shows the hip joint of a human patient, in section. The hip joint comprises a head of the femur 5 located in the upper part of the neck of the femur 6, which is the upper part of the femoral bone 7. The head of the femur is in connection with the acetabulum 8, which is a part in bowl shape of the pelvic bone 9. Both the surface 10 of the femur head and the surface 11 of the acetabulum are covered with articular cartilage 13, which acts as a shock absorber in the hip joint. In patients with osteoarthritis of the hip joint, this articular cartilage 13 is abnormally worn due to low intensity inflammation. The hip joint is surrounded by the capsule 12 of the hip joint, which provides support for the joint and prevents dislocation. After a conventional surgery of the hip joint, which penetrates the capsule 12 of the hip joint, the capsule 12 weakens dramatically due to the limited possibilities of healing of its ligament tissue. By performing a surgery of the hip joint without damaging the capsule 12 of the hip joint, the patient can recover completely and perform an amount of effort in an artificial joint that is possible in a natural joint.

Figure 2 shows a side view of a conventional surgery of the hip joint in which an incision 112 has been made in the tightening 113 that allows the surgeon to reach the femur 7 in which the head of the femur 5 is located. A conventional hip joint surgery, the hip joint is accessed through the hip joint capsule, resulting in a large scar.

Figure 3 shows the placement of an artificial surface 45 of the head of the femur over the head of the femur 5, in conventional surgery.

To allow the provision of material that can be used as a support contact surface in the hip joint, it is necessary to access the hip joint. Referring to Figure 1, this could be through a hole made in the pelvic bone 9, in the femoral bone 7 or in the capsule 12 of the hip joint.

Figure 4 shows the hole 18 in the pelvic bone 9 according to a first embodiment, the hole 18 is large, which allows a prosthesis to pass through said hole 18 in its fully functional size.

Figure 5 shows the hole 20 according to a second embodiment, in which the hole 20 created in a surgical or laparoscopic procedure is much smaller, which allows the surgical instrument that creates the hole to be smaller, and therefore the incision and dissection performed in the human body.

Figure 6 shows the hip joint in section when a hole is created in the femur 7. The hole in the femur passes through the head of the femur 5 to the hip joint and allows the surgeon to reach the joint of the hip.

5

10

fifteen

twenty

25

30

35

40

Four. Five

fifty

55

Figure 7 shows the hip joint in section during the creation of a hole in the capsule 12 of the hip joint. The hole in the hip joint capsule passes to the hip joint and allows the surgeon to reach the hip joint.

Before the introduction of closure elements or materials in the hip joint, it may be necessary to prepare the surfaces of the hip joint. This preparation could be carried out by widening the acetabulum and / or the surface of the femur head.

Figure 8 shows a stretcher according to a first embodiment, wherein said stretcher is expandable. The expandable stretcher comprises at least one widening blade 40 comprising a widening surface 41a, b. Said expandable stretcher could be adapted to widen the acetabulum 8, the head of the femur 5 or both. In the embodiment in which said expandable stretcher is adapted to widen the acetabulum 8, said widening surface 4la is located on the outside of at least one widening blade 40, while in the embodiment in which said stretcher expandable is adapted to widen the head of the femur 5, said widening surface 41b is located on the inside of at least one widening blade 40. According to a second embodiment, said expandable stretcher is adapted to widen both the acetabulum as the head of the femur, in which case the stretcher has widening surfaces 41a, b in both the outer and inner parts of at least one widening blade 40.

Figure 9 shows the expandable stretcher according to the first embodiment, in which the widening blades 40 can be folded towards the center of the hemisphere that produces the expandable stretcher in its expanded situation, shown in Figure 15. The folding of the blades Widening 40 allows the expandable stretcher to be introduced into a hip joint through a hole smaller than the area that can be widened using said expandable stretcher.

Figure 10 shows the mentioned interior of the expandable stretcher with the widening blades 40. In the embodiment, when the expandable stretcher is adapted to widen the head of the femur, said inner side of at least one widening blade 40 comprises a widening surface 41b.

Figure 11 shows the expandable stretcher according to any of the embodiments, when it widens the acetabulum 8 and / or the head of the femur 5. The stretcher can be adapted to be operated manually or by means of a rotating, vibrating or oscillating drive device.

To get an inside view of the hip joint, it is conceivable that the surgeon can make a second hole in the pelvic bone, the femoral bone or the hip joint capsule to insert a chamber.

Figure 12 shows the hip joint in section, in which a second hole 18b in the pelvic bone 9 allows the surgeon to place a chamber 34 in the hip joint, preferably used in a laparoscopic procedure.

Figure 13a shows an instrument for placing the first and / or second closure elements in the hip joint through a hole in the pelvic bone, the femur or the hip joint capsule. The instrument comprises a piston 89 for transporting said first and / or second closure elements to the hip joint.

Figure 13b shows a section of the surgical instrument, comprising a tube type element 90 for housing said first and / or second closure elements.

Figure 13c shows the surgical instrument according to another embodiment in which the surgical instrument comprises a flexible or bent part 91 that improves the scope of the surgical instrument. The surgical instrument according to any of the embodiments can be used to place said first or second closure elements inside the hip joint, in any of the ways described in the following embodiments.

Figure 14a shows an instrument adapted to introduce the first and / or the second closure elements in the hip joint, according to a second embodiment. According to this embodiment, the surgical instrument comprises a grip part 76 and a manipulation part 77. According to the embodiments shown in Figure 14a, b, c, the instrument further comprises a rotation element 78 that allows the grip part 76 rotates in relation to the handling part 77, although it is also conceivable that the surgical instrument lacks this rotating element 78.

Figure 14b shows the surgical instrument adapted to introduce the first and / or second closure elements in the hip joint, according to a third embodiment. According to this embodiment, the surgical instrument further comprises a parallel displaced section 79, which increases the scope of the instrument and facilitates access to the hip joint through a hole in the pelvic bone, femoral bone or capsule. the hip joint.

5

10

fifteen

twenty

25

30

35

40

Four. Five

fifty

55

Figure 14c shows the surgical instrument adapted to introduce the first and / or the second closure elements in the hip joint, according to a third embodiment. According to this embodiment, the surgical instrument further comprises two adjustment elements of angle 80a, b. The angle adjustment elements may be adjustable to vary the angle of said grip portion 76 with respect to the manipulation portion 77, or be fixed at an angle suitable for operating at a hip joint through a hole in the pelvic bone, femur or hip joint capsule.

Figure 15 shows the articulation of the hip in section, in which a first closure element 84 has been introduced through a hole 18 in the pelvic bone 9 using an instrument adapted for it 85. The step of placing said First closure element 84 can be carried out in a surgical or laparoscopic procedure.

Figure 16a shows the articulation of the hip in section, in which a second closure element 86 has been introduced through a hole in the pelvic bone 9 in a surgical or laparoscopic procedure. The first 84 and the second 86 closing elements create a closed space 87 between the acetabulum 8 and the head of the femur 5, adapted to be used as a mold for the arrangement of an artificial acetabulum 65 and / or a surface 45 of the head of the femur.

Figure 16b shows a surface 45 of the head of the artificial femur in an embodiment in which the surface of the head of the artificial femur comprises a first pre-assembled closure element 84. The preassembled closure element 84 is adapted to be placed in contact with the acetabulum, or with an artificial substitution thereof. The surface 45 of the head of the artificial femur with the closure element 84 is adapted to be implanted in the hip joint of a patient and create in it a closed hollow space, adapted to receive a material, together with the acetabulum, or an artificial substitution thereof. The closure element may be attached to the surface of the femur head using an adhesive or the shape of the surface 45 of the artificial femur head.

Figures 17a, b, c show an alternative approach for placing said first closure element 84 in the hip joint of a human patient. Said alternative approach comprises the steps of creating a hole 82 in the femur 7 along a longitudinal axis of the neck of the femur 6, as shown in Figure 17a, said hole starting from the lateral side of the thigh, penetrating the cortex of the femur 7 and finally reaching the cortex of the femur head 5 from the inside thereof, said cortex penetrating and entering the hip joint. After the creation of the hole 82 in the femur 7, the first closure element 84 is introduced into the hip joint through the hole 82 using a surgical instrument 88 adapted thereto, as shown in Figure 17c. This approach can also be used to place a second closure element 86 in the pelvic bone 9 or in the femur 7 through the hole 82 in the femur 7.

Figure 18 shows a third approach for placing a first closure element 84 inside the hip joint. In accordance with this approach, the first closure element 84 is placed in the hip joint through the capsule 12 of the hip joint.

In addition, it is conceivable that the first closure element 84 is placed in the hip joint using any of the foregoing approaches, while the second closure element 86 is placed in the hip joint using another of the foregoing approaches.

Figure 19 shows the sectional hip joint, where an injector element 92 injects a fluid 93 into a closed area 87 into the hip joint, through a hole 18 in the pelvic bone 9 from the opposite side with respect to acetabulus 8. said closed area being 87 closed by a first 84 and a second 86 closing elements. The injector element 92 comprises a piston 94 that pushes said fluid 93 to the closed area 87. Said fluid 93 is adapted to harden, whether by the use of a catalyst agent or not. After said fluid 93 has hardened, it is adapted to serve as the surface of the hip joint.

Figure 20 shows the sectional hip joint, in which an injector element 92 injects a fluid 93 into the closed area 87, according to the second approach. In this approach, an injector element 92 injects a fluid 93 into the closed area 87 in the hip joint, through a hole 82 in the femur 7. With said closed area 87 being closed by at least a first element of closure 84, and possibly a second closure element 86. The injector element 92 comprises a piston 94 that pushes said fluid 93 to the closed area 87.

Figure 21 shows the sectional hip joint, in which an injector element 92 injects a fluid 93 into the closed area 87, according to the third approach. In this approach, an injector element 92 injects a fluid 93 into a closed area 87 in the hip joint, through the capsule 12 of the hip joint.

Figure 22a shows the closed area 87 closed by the first 84 and the second 86 closing elements, together with the head of the femur 5 and the pelvic bone 9. A fluid adapted to harden 93 has been injected into the closed area, and after hardening of said fluid, this provides at least one surface of the hip joint.

5

10

fifteen

twenty

25

30

35

40

Four. Five

fifty

55

Figure 22b shows an injector element 105 by injecting a fluid in said closed area 87 into the hip joint, through a closure element 84. The injector element 105 comprises a needle to penetrate the closure element 84, which preferably comprises a self-sealing material, such as silicone. According to an alternative embodiment (not shown), the closure element comprises a tubular element that penetrates the closure element, through which the material can be injected. The tubular element could be adapted to be made of the same material as the closure element and arrive from the area of the hip joint and to the outside of the body, where it could be connected to an injector element. The tubular element could be made of resorbable material, or of a material adapted to melt.

Figure 23 shows a lateral section of the human body, in which an injector element 92 injects a fluid in said closed area 87 into the hip joint, through a hole 18 in the pelvic bone 9 from the opposite side with respect to the acetabulum 8.

Figure 24 shows the injector element 105 according to any of the above embodiments, adapted to inject fluid 93 to a closed area 87 or to a connection area between the pelvic bone 9 and a prosthetic part, the pelvic bone 9 and a bone block 31, or the head of femur 5 and a prosthetic part. Said injector element comprises a container 107 adapted to contain a fluid for injection. According to a first embodiment, said container comprises two compartments 108a, b adapted to contain two different fluids, said fluids being adapted to harden when mixed. In the embodiment in which the container 107 is adapted to contain two fluids, it is conceivable that the injector element 105 also comprises a mixing element 109 in which said two fluids are mixed before injection. According to a second embodiment (not shown) said container 107 is adapted to keep said fluid sterile. According to a third embodiment (not shown) said container 107 is adapted to keep said fluid hot or cold, and according to a fourth embodiment (not shown) said container 107 is adapted to keep said fluid in a dark environment. In addition, a combination of the aforementioned embodiments is conceivable.

According to any of the above embodiments, said two fluids could be adapted to harden when mixed, in which case one of the fluids could be a catalyst agent. It is also conceivable that one of said two fluids is a gas, such as nitrogen gas, which acts as a catalyst when mixed with said first fluid. Said first fluid, second fluid or mixed fluid could also be adapted to harden by means of UV light, a thermal change or contact with a body fluid.

Figure 25 shows an injector element 105 in which the injector element comprises a part or section adapted to bend. The instrument could be adapted to bend when said injector element is flexible, shown in Figure 25, or comprising at least one joint 1050, shown in Figure 26.

Material

The closed area can be filled with a solution comprising multiple fluids. According to one embodiment, said first fluid is the same as said second fluid comprising a hardenable component, and stabilization is initiated by adding a polymerization initiator, a catalyst, subjecting the fluid to radiation, or subjecting said fluid to a temperature change. . In this embodiment, the closed area is filled with a fluid comprising a hardenable component, which can be stabilized at a desired time. There are several polymerization initiators and catalysts well known to those skilled in the art, and a suitable initiator or catalyst can be chosen when the monomer or monomers have been chosen. The radiation can be any of ultraviolet, infrared and X-rays, depending on the injected material. It has also been conceived that the radiation takes place before the hardenable component is introduced into the device, initiating a polymerization which continues below and is completed inside the device. Said second fluid is, for example, a fluid with a melting point sufficiently above normal body temperature to solidify at body temperature, but not so high that it endangers the health of the patient when it is in molten form. It is contemplated that a suitable temperature difference is at least about 4 ° C, preferably about 6 ° C or greater.

Alternatively, said hardenable component is a component that can change from fluid to solid when exposed to a gaseous component, and in which said hydraulic device implanted in the body does not contain gas.

The hardenable component is preferably a biocompatible component.

In addition, in embodiments, the curable component and at least one chamber containing said component are preferably maintained in sterile conditions. Accordingly, one embodiment comprises the use of a sterile tank containing the hardenable component, and the process includes the steps of moving the sterile hardenable component from sterile conditions from said deposit to the closed area. In addition, according to another embodiment, the curable component comprises two sterile substances and the process includes, before the introduction of said substances into the body, the step of mixing said substances under sterile conditions.

5

10

fifteen

twenty

25

30

35

40

Four. Five

fifty

55

According to one embodiment, said polymer is a thixotropic gel.

In combination with any of the above, it is preferable that said polymer be a biocompatible polymer.

According to a specific embodiment, said polymer is chosen from polymers of polyhydroxy acid and copolymers such as poly-L-lactide, poly-DL-lactide, polyglycolic acid and polydioxanone.

In combination with any of the above embodiments, it is also contemplated that said polymer also comprises reinforcing particles. Said reinforcing particles are preferably chosen from particles of biocompatible ceramics or fibers composed of calcium phosphates.

In another embodiment, optionally combined with any of the foregoing, said composition further comprises a crosslinker or a polymerization initiator.

Similarly, optionally combined with any of the foregoing, said composition also comprises a propellant. Useful propellant agents comprise, but are not limited to, compressed gases, such as air, nitrogen, oxygen or compressed noble gases; liquefied propellants such as liquefied propane, isobutene, n-butane or a mixture thereof, dimethyl ether; or chlorofluorocarbons.

Examples of suitable biocompatible polymers that may be used include polymers selected from the group consisting of aliphatic polyesters, poly (amino acids), copoly (ether esters), polyalkylene oxalates, polyamides, poly (iminocarbonates), polyorthoesters, polyoxaneses, polyamidoesters, polyoxaesters containing amino groups, poly (anhydrated), polyphosphazenes, biomolecules (ie, biopolymers such as collagen, elastin, bioabsorbable starches and the like) and mixtures thereof. Aliphatic polyesters include, but are not limited to, homopolymers and copolymers of lactide (including lactic acid, D-, L- and meso lactide), glycolide (which includes glycolic acid), epsilon-caprolactone, p-dioxanone (1,4 -dioxan-2-one), trimethylene carbonate (1,3-dioxan-2-one), alkyl derivatives of trimethylene carbonate, delta-valerolactone, beta-butyrolactone, gamma-butyrolactone, epsilon-decalactone, hydroxybutyrate (units repeated), hydroxivalerate (repeated units), 1,4-dioxepane-2-one (including its 1,5,8,12-tetraoxacyclotetradecane-7,14-dione), 1,5-dioxepane-2-one, 6 , 6-dimethyl-1,4-dioxan-2- one 2,5-diketomorpholine, pivalolactone, alpha, alpha-diethylpropiolactone, ethylene carbonate, ethylene oxalate, 3-methyl-1,4-dioxan-2,5- dione, 3,3-diethyl-1,4-dioxan-2,5-dione, 6,8-dioxabicyclooctane-7-one and polymer mixtures thereof. Poly (iminocarbonates) include those described by Kemnitzer and Kohn, in the Handbook of Biodegradable Polymers, edited by Domb, Kost and Wisemen, Hardwood Academic Press, 1997, pages 251 to 272. Copoli (ether-esters) for the purpose of this invention include the copolyester ethers described in the "Journal of Biomaterials Research", volume 22, pages 993 to 1009, 1988, of Cohn and Younes and Cohn, Polymer Preprints (ACS Division of Polymer Chemistry) volume 30 (1) , page 498, 1989 (for example, PEO / PLA). Polyalkylene oxalates for the purpose of this invention include those mentioned in U.S. Pat. numbers 4,208,511; 4,141,087; 4,130.6.39; 4,140,678; 4,105,034; and 4,205,399 (incorporated by reference herein). Polyphosphazenes, polymers based on co-, ter- and higher order mixed monomers manufactured from L-lactide, D, L-lactide, lactic acid, glycolide, glycolic acid, para-dioxanone, trimethylene carbonate and epsilon-caprolactone described, among others, by Allcock in The Encyclopedia of Polymer Science, volume 13, pages 31 to 41, Wiley Intersciences, John Wiley & Sons, 1988 and by Vandorpe, Schacht, Dejardin and Lemmouchi in the Handbook of Biodegradable Polymers, edited by Domb, Kost and Wisemen, Hardwood Academic Press, 1997, pages 161 to 182 (which are incorporated by reference herein). Polyanhydrates from diacids of the form HOoC-C6H4-O- (CH2) mO-C6H4-COOH where m is an integer in the range of 2 to 8, and copolymers thereof, with aliphatic alpha-omega diacids of up to 12 carbons

Polyoxaesters, polyoxamides and polyoxaneses containing amines and / or amido groups are described in one or more of the following U.S. Pat. numbers 5,464,929; 5,595,751; 5,597,579; 5,607,687; 5,618,552; 5,620,698; 5,645,850; 5,648,088; 5,698,213; 5,700,583; and 5,859,150 (which are incorporated by reference herein). Polyortoesteres such as those described by Heller in the Handbook of Biodegradable Polymers, edited by Domb, Kost and Wisemen, Hardwood Academic Press, 1997, pages 99 to 118 (incorporated by reference herein).

The term "biocompatible" is defined as the ability of a biomaterial to carry out its desired function with respect to a medical therapy, without causing any undesirable local or systemic effect on the recipient or beneficiary of said therapy, but generating the cellular response. or of more suitable beneficial tissue in said specific situation, and optimizing the clinically relevant result of said therapy (David F. Williams, "On the mechanisms of biocompatibility" Biomaterials, volume 29, number 20, July 2008, pages 2941 to 2953) .

Keep in mind that any realization or part of realization, as well as any procedure or part of procedure, can be combined in any way. All examples in this report should be considered as part of the general description and, therefore, suitable to be combined in any way, in general terms.

Claims (13)

5 10 fifteen twenty 25 30 35 40 Four. Five fifty 1. A medical device for the treatment of osteoarthritis of the hip joint contributing to the injection of an artificial surface of the hip joint on the natural surface of the hip joint or on a natural surface of the hip joint. the surgically modified hip, wherein said medical device comprises a first closure element (84) adapted to be placed in the hip joint to create a hollow space together with the acetabulum, or an artificial replacement thereof, and the head of the femur , or an artificial substitution (45) thereof, wherein said first closure element has an elongated body adapted to close said hollow space confined by the surfaces of the acetabulum, or of an artificial replacement thereof, and of the head of the femur, or of an artificial substitution thereof, in order to receive, within said hollow space, a material (93) for coating minus one of the acetabulus and the head of the femur, where said medical device further comprises a second closure element (86), in which - said first and second closing elements define a closed hollow space (87) together with the head of the femur, or an artificial substitution thereof, and the acetabulum, or an artificial substitution thereof, and - said first and second closure elements are adapted to make contact with said material when said hollow space receives said material to cover at least one of the surface of the acetabulum and the surface of the head of the femur, and in which the device comprises said material, characterized in that said material is biocompatible and is adapted to be injected in such a way that it comes in contact with said first closure element, and in which said biocompatible material is adapted to transform from a fluid state to a solid state after said material has been injected in said provisional mold, and in which said material is adapted to have a surface that tolerates wear and pressure when said material is in said solid state. 2. The medical device according to claim 1, wherein said first closure element comprises an opening adapted to receive said material to cover at least one of the surface of the acetabulum and the surface of the femur head. 3. The medical device according to any of claims 1 to 2, wherein said first closure element defines a closed hollow space together with at least one of; - said artificial replacement of the head of the femur, and the acetabulum, and wherein said opening of said first closure element is adapted to receive said material to cover said at least one surface of the hip joint, - said artificial replacement of the acetabulum, and the head of the femur, and wherein said opening of said first closure element is adapted to receive said material to cover said at least one surface of the hip joint, and - said artificial replacement of the head of the femur and said artificial replacement of the acetabulum, and wherein said opening of said first closure element is adapted to receive said material, to create an intermediate contact surface between said artificial replacement of the head of the femur and said artificial replacement of the acetabulum, surface of the hip joint. 4. The medical device according to any of claims 1 to 3, wherein at least one of said first and second closure elements is adapted to be at least one of; introduced into the hip joint through a hole in any of: the pelvic bone, the femoral bone and the hip joint capsule, in which said first closure element is adapted to be introduced into the articulation of the hip through said hole, said second closure element is adapted to close said hole. 5. The medical device according to any one of claims 1 to 4, wherein said at least one closure element is adapted for at least one of; be resorbable and melt after having served its purpose as a closing element. 6. The medical device according to any one of claims 1 to 5, further comprising at least one of; a surface of the head of the artificial femur and a surface of the artificial acetabulus, adapted to replace the surface in a hip joint, wherein said first closure element comprises an integrated part of said surface of the head of the artificial femur or said surface of the artificial acetabulus. 7. The medical device according to any of the preceding claims, further comprising an injector element (92) in connection with at least one of said first and second closure elements, adapted to inject material into said hollow space, in wherein said injector element adapted to inject material into said hollow space comprises at least one container (107), and at least one of; 5 10 fifteen twenty 25 30 35 - a material injector element in connection with at least one of said first and said second closure elements, and a material supply element in connection with said material injector element, and - a fluid conduit and a fluid injection element adapted to be in connection with said mold. 8. The medical device according to claim 7, wherein said injector element further comprises a second container, and wherein said first (108a) and second (108b) containers are adapted to contain different fluids, wherein said adapted injector element to inject material into said hollow space it also comprises at least one of; - a mixing unit adapted to mix said fluids contained in said at least two containers, and - one of said two different fluids adapted to act as catalyst agent. 9. The medical device according to any of claims 7 to 8, wherein said injector element is adapted for at least one of: inject a material adapted to harden, inject a material adapted to harden by means of UV light, inject a material adapted to harden by means of a gas that serves as a catalyst, be bent, be folded at a fixed angle, and be folded at an adjustable angle. 10. The medical device according to any of the preceding claims, wherein said at least one closure element comprises at least one of; a polymer material, a silicone based material, a latex based material, and A biocompatible material. 11. The medical device according to any of the preceding claims, further comprising at least one heating element adapted to heat the material, wherein said heating element is adapted to heat the material at a temperature in the range of 40 to 60 degrees Celsius, or in the range of 60 to 90 degrees Celsius, or in the range of 90 to 200 degrees Celsius, or in the range of 200 to 400 degrees Celsius or more than 400 degrees Celsius. 12. The medical device according to any of the preceding claims, wherein said material is a material having a melting point in the range of 40 to 60 degrees Celsius, or in the range of 60 to 90 degrees Celsius, or in the range of 90 to 200 degrees Celsius, or in the range of 200 to 400 degrees Celsius or more than 400 degrees Celsius. 13. The medical device according to any of the preceding claims, wherein said material is a material selected from the group consisting of: to. polytetrafluoroethylene, b. perfluoroalkoxy C. fluorinated ethylene-propylene, d. polyethylene, and and. Acrylic polymer mixed with alumina trihydrate.